Job Description

Summary

Revenue Cycle Analyst will perform many accounting, customer service and organizational tasks to promote the financial health of CSI Pharmacy. Duties include ensuring accuracy and efficiency to process and bill patient prescription orders in a timely manner while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers. The reimbursement Liaison must comply with established policies and procedures as well as assist in the creation of new policies to establish best practice.

Essential Duties and Responsibilities

include the following. Other duties may be assigned, as necessary.

• Facilitate escalations and appeals process for Commercial, Medicare and other government payers
• Assist with training and education with current staff and all new hires
• Create training presentations for department processes and procedures
• Work closely with intake and pharmacy to ensure best practices for new start of cares. 
• Assist/maintain payer setups and payer pricing modules in CareTend; maintain Contracted Rates Pricing spreadsheet
• Add new payers to CareTend; including contact, billing/pricing and portal information
• Review and resolve outstanding payment issues in a timely manner
• Prepare and submit clean claims to both the patients and insurance companies as needed.
• Perform day to day financial transactions, including verifying, classifying, computing, posting, and recording accounts receivables data
• Facilitate payment of invoices due by sending bill reminders, contacting insurance companies, and contacting patients to resolve outstanding issues
• Answer questions from patients, clerical staff, and insurance companies.
• Follow and report status of delinquent accounts.
• Participate in educational activities and attends monthly staff meetings.
• Conduct self in accordance with employee manual.
• Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Perform all special projects given in a timely manner
• Perform other related duties as assigned or requested
• Enroll payers in Waystar for EDI management; ERAs, claims, eligibility and denial management
• EFT enrollments via payer portals; assist Managed Care representative with enrollment applications
• Payer Instructions sheets for existing and new contracted payers; including intake, billing and reimbursement information
• Assist with rollout and training in Waystar; including set up users, department settings

Qualification Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Provide the highest level of professionalism, responsiveness, and communication to build and maintain the maximum customer base possible. 
• Must possess the ability to multi-task and frequently change direction. 
• Computer skills including the ability to operate computerized accounting, spreadsheet, word-processing programs, and email at a highly proficient level 

• Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction 
• Good verbal and written communication skills 
• Problem analysis and problem-solving skills 
• Knowledge of office administration and procedures 
• Stress management skills 
• Time management skills 

Education and/or Experience

• High School Diploma/GED  
• College degree preferred or equivalent experience. 
• 5-7 years accounts receivable and home infusion experience 

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, climb stairs, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

The employee frequently lifts and/or moves up to 50 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

This job generally operates in a clerical office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines. While performing the duties of this position, the employee may travel by automobile and be exposed to changing weather conditions.

Comments

This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time.

NOTICE: Successful completion of a drug screen prior to employment is part of our background process, which includes medical and recreational marijuana.

By supplying your phone number, you agree to receive communication via phone or text.

By submitting your application, you are confirming that you are legally authorized to work in the United States.

JR# JR247513